# Rising Mortality From Chronic Liver Disease in Young US Adults: A Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER)-Based Analysis

## TL;DR

Chronic liver disease is causing more deaths in young US adults, especially among men and certain racial groups, highlighting the need for better prevention and care.

## Contribution

This study reveals rising mortality from chronic liver disease in young US adults and identifies significant racial disparities.

## Key findings

- CLD mortality increased in all age and sex subgroups from 2000 to 2020.
- AI/AN men aged 35-44 had the highest CLD mortality rates.
- Racial disparities in CLD mortality were statistically significant across all groups.

## Abstract

Background: Chronic liver disease (CLD), traditionally considered a condition of older adults, has shown increasing mortality in younger US adults. Rising rates of alcohol-related liver disease and metabolic dysfunction-associated steatotic liver disease (MASLD) have shifted the demographic profile of CLD burden.

Objective: This study aimed to identify significant trends and disparities in CLD mortality among US adults aged 25-44 years from 2000 to 2020, with analysis stratified by age subgroup, sex, and race/ethnicity.

Materials and methods: We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Underlying Cause of Death database. Deaths attributed to CLD were identified using International Classification of Diseases 10th Revision (ICD-10) codes K70 (alcoholic liver disease), K73 (chronic hepatitis), and K74 (fibrosis and cirrhosis). Data were stratified by age (25-34 and 35-44), sex, and race. Crude death rates per 100,000 were calculated. One-way analysis of variance (ANOVA) was performed to evaluate racial disparities within subgroups.

Results: CLD mortality increased in all subgroups from 2000 to 2020. The highest rates were observed among men aged 35-44, particularly American Indian or Alaska Native (AI/AN) men, who reached an average of 19.4 deaths per 100,000. Black men and Hispanic women also experienced significant increases. ANOVA confirmed statistically significant racial disparities (p<0.0001) within all sex and age groups.

Conclusion: CLD mortality is rising among young US adults, with disproportionately high rates in AI/AN and Black populations. These findings underscore the need for earlier screening, expanded public health interventions, and targeted support for underserved communities.